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Nurse champions access to dental care for at-risk kids

Registered Dental Hygenist James Fung speaks with Alphonz Aju in the Region of Peel mobile dental bus, in the parking lot of the Brampton East Dental Clinic. (J.P. MOCZULSKI / The Toronto Star)

Poonam Sharma, a public health nurse in Peel Region, poses beside a travelling dental bus in the parking lot of the Brampton East Dental clinic in Brampton, Ont. The bus is part of a program that helps at-risk children who would not otherwise have access to dental care. (J.P. MOCZULSKI / The Toronto Star)

Access to free health care is a right for every Canadian, but the same can’t be said for dental care, which often ends up being sacrificed by the country’s low-income families.

The latest estimates suggest six million Canadians avoid going to the dentist, mainly because it’s too cost prohibitive, and children are among those suffering some of the biggest consequences as a result.

“Really, it’s an inequity,” says Poonam Sharma, a public health nurse in Peel Region, who has become part of the local solution to this national problem.

Sharma is championing several community outreach programs in Peel aimed at helping at-risk children who would not otherwise have access to dental care.

A travelling dental bus, portable clinics in the community and fixed dental clinics are all ways the region — which includes the cities of Brampton, Caledon and Mississauga — has been trying to ensure children aren’t suffering the pitfalls of poor oral health.

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“For many of them, it’s their first exposure to a dental health professional,” says Sharma, adding hygienists doing screenings will sometimes find severe decay and cavities in children who haven’t seen a dentist.

“Poverty is one of the main social determinants of poor overall health, and overall health includes oral health,” she says. “What we’re trying to do is make families understand how important the health of their children’s mouth is. Your mouth has to be healthy, because it impacts children in so many different ways.”

Sharma says research shows poor dental hygiene affects a child’s emotional health as well, sometimes leading to embarrassment, especially when they have missing or broken teeth. “It affects their self-esteem, their confidence, which impacts their social relationships with their peers,” she says.

Sharma notes many parents may be completely unaware their child has dental pain, which could be affecting their ability to concentrate at school or even sleep at night, which could have a ripple effect.

“It may cause irritability, behavioural problems,” she says. “It will affect their school attendance, so, overall, it’s going to affect their performance in school.”

Dental pain can also affect overall growth and development, she says, with children not being able to chew properly, or not eating as much as they should be.

Sharma, who worked in a dental clinic for 17 years before becoming a nurse, has made it her mission to see children get proper dental attention.

During the 2014-2015 school year, Peel Public Health screened 52,462 children, and about 40 per cent were identified with a dental need.

The travelling bus, which operates between April and October, saw 900 children last year for services ranging from cleanings, fluoride treatments and dental sealants to education about oral health.

Peel Public Health also collaborates with the Bramalea Community Health Centre and the East Mississauga Community Health Centre, as well as dentists in the community, to deliver free oral health care for children under the Healthy Smiles Ontario (HSO) program.

More than 323,000 children from low-income families are now getting free dental care through the newly expanded HSO program, which is available to kids who are 17 or under, Ontario residents and meet certain financial-needs criteria.

Peel’s travelling bus goes into specific communities, to local events, churches and festivals to try and promote the HSO program and help families enrol. Once they get a card for HSO, they can go to any dental clinic in Peel for a free visit.

Sharma says for many, education is one of the biggest barriers to healthy mouths, and while cavities are completely preventable, they are the most common chronic childhood disease.

The latest stats for Peel Region reveal 52 per cent of children in Grades 10 and 12 have experienced cavities, with 41 per cent of children in Grade 2, and 27 per cent of kids in junior and senior kindergarten, having already required fillings.

Tooth decay is the leading cause of day surgeries for children ages one to five in Ontario, and rates are four times higher for children from less affluent neighbourhoods.

Seeing a dental professional regularly, not just for children, but for all ages, helps to maintain healthy lives, stresses Sharma.

“When there’s bacteria in your mouth; it can spread to other parts of our body,” she warns. “What the research is now telling us is there is a connection between poor oral health and systemic diseases, such as diabetes and respiratory disease, and there’s even newer evidence showing a link to heart disease and premature, low-birth babies. A lot of people don’t realize that; how important it is.”

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